Background And Objectives: The DOSE index, which incorporates Dyspnea, Obstruction, Smoking, and Exacerbations, is a widely used tool for assessing the severity and prognosis of Chronic Obstructive Pulmonary Disease (COPD). In addition to risk assessment, it has potential clinical utility in predicting healthcare costs, which are primarily driven by exacerbations. While several indices, such as the BODE (Body-mass index, Obstruction, Dyspnea, Exercise) and ADO (Age, Dyspnea, Obstruction) indices, exist for risk prediction, there is a lack of dedicated tools for forecasting healthcare costs. This study explores the potential of the DOSE index compared to other indices, including BODE, ADO, and the Charlson Comorbidity Index (CCI), for this purpose.
Materials And Methods: This cross-sectional retrospective study analyzed data from 396 COPD cases. We examined associations between the DOSE index, BODE index, ADO index, CCI, and healthcare costs, including hospitalizations and emergency room treatments. Healthcare costs were categorized as direct medical expenses.
Results: Significant associations were observed between the DOSE index and various healthcare parameters. DOSE quartiles showed strong correlations with outpatient visits (p = 0.013) and outpatient medical expenses (p = 0.011). In addition, hospitalization frequency, duration, and associated costs were significantly correlated with higher DOSE quartiles (p < 0.001). A significant difference was found when comparing DOSE quartiles between patients with high (CCI ≥ 3) and low (CCI < 3) comorbidity scores (p = 0.018). The DOSE index outperformed other indices, likely due to its inclusion of exacerbations, a key driver of healthcare costs.
Conclusion: The DOSE index demonstrates potential in predicting healthcare costs, particularly due to its inclusion of exacerbation frequency. This study highlights the importance of considering exacerbations alongside traditional risk factors for more accurate cost forecasting in COPD management. Our findings suggest that the DOSE index may be a valuable tool in both clinical and economic assessments of COPD patients, though further research is warranted to validate these findings in larger datasets.
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http://dx.doi.org/10.1186/s12890-024-03368-0 | DOI Listing |
BMC Health Serv Res
December 2024
Open Medical Ltd, London, UK.
Background: The UK's National Health Service (NHS) is grappling with rising demand and limited dermatologists, leading to longer waiting times. This is particularly concerning for conditions like malignant melanoma, where early diagnosis is crucial. Teledermatology is being introduced to address these issues, but its impact on patients' monetary and time costs, especially in deprived areas, is under-researched.
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December 2024
Women's Health Research Group, Leeds Institute of Medical Research, St James's University Hospital, University of Leeds, Wellcome Trust Brenner Building, Beckett Street, Leeds, LS9 7TF, UK.
The histopathology workforce is a cornerstone of cancer diagnostics and is essential to the delivery of cancer services and patient care. The workforce has been subject to significant pressures over recent years, and this review considers them in the UK and internationally. These pressures include declining pathologist numbers, the increasing age of the workforce, and greater workload volume and complexity.
View Article and Find Full Text PDFBMC Health Serv Res
December 2024
Department of Cardiac Surgery, Allama Iqbal Medical College, Lahore, Pakistan.
Enhanced Recovery After Surgery (ERAS) is a cost-effective perioperative approach that has been shown to shorten patients' hospital length of stay, improve resource utilization, and reduce postoperative costs for both patients and hospitals. While ERAS has the potential to offer even greater benefits in low- and middle-income countries (LMICs) its successful long-term implementation remains incomplete in Pakistan. This study aimed to explore insights and identify opportunities for implementing ERAS within the local socio-environmental context.
View Article and Find Full Text PDFBMC Complement Med Ther
December 2024
Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
Background: Acute postoperative pain is often reported after repair of inguinal hernia and can negatively impact patient satisfaction and clinical outcomes. This includes delayed wound healing, longer hospitalization, and increased health care costs. Non-pharmacological techniques like Progressive Muscle Relaxation (PMR) and Rhythmic Breathing (RB) have been suggested as possible interventions for managing this type of pain.
View Article and Find Full Text PDFAm J Geriatr Psychiatry
November 2024
Department of Bioethics (CRM, SH, SYK), Clinical Center, National Institutes of Health Clinical Center, Bethesda, MD. Electronic address:
Objective: The new antiamyloid medications Lecanemab (Leqembi) and donanemab (Kisunla) are the first disease-modifying treatments for Alzheimer's disease (AD) to receive full FDA approval. However, some commentators question whether the drugs' benefits outweigh their risks, burdens, and costs to patients. This study assessed the perceived value of these medications by asking caregivers of persons with AD to compare them to a widely used intervention in AD management: home-based care.
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